Provider Demographics
NPI:1376294793
Name:GREATER FAMILY HEALTH
Entity Type:Organization
Organization Name:GREATER FAMILY HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING LEAD
Authorized Official - Prefix:
Authorized Official - First Name:MARLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HURTADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-608-6318
Mailing Address - Street 1:370 SUMMIT ST
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60120-3843
Mailing Address - Country:US
Mailing Address - Phone:844-599-3700
Mailing Address - Fax:847-841-6739
Practice Address - Street 1:10225 GRAND AVE
Practice Address - Street 2:
Practice Address - City:FRANKLIN PARK
Practice Address - State:IL
Practice Address - Zip Code:60131-3138
Practice Address - Country:US
Practice Address - Phone:844-599-3700
Practice Address - Fax:847-841-6739
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GREATER FAMILY HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-01-18
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)